Provider Demographics
NPI:1821368408
Name:MARY MERLA-RAMOS, PH.D. LLC
Entity Type:Organization
Organization Name:MARY MERLA-RAMOS, PH.D. LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:MERLA-RAMOS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:732-715-4999
Mailing Address - Street 1:560 MAIN ST
Mailing Address - Street 2:SUITE 1G
Mailing Address - City:LOCH ARBOUR
Mailing Address - State:NJ
Mailing Address - Zip Code:07711-1231
Mailing Address - Country:US
Mailing Address - Phone:732-775-6500
Mailing Address - Fax:
Practice Address - Street 1:560 MAIN ST
Practice Address - Street 2:SUITE 1G
Practice Address - City:LOCH ARBOUR
Practice Address - State:NJ
Practice Address - Zip Code:07711-1231
Practice Address - Country:US
Practice Address - Phone:732-775-6500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-12
Last Update Date:2012-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35SI00485800261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)